Abstract

Background

Psychological stress occurs when an individual perceives that environmental demands
tax or exceed his or her adaptive capacity. Its association with severe health and
emotional diseases, points out the necessity to find new efficient strategies to treat
it. Moreover, psychological stress is a very personal problem and requires training
focused on the specific needs of individuals. To overcome the above limitations, the
INTERSTRESS project suggests the adoption of a new paradigm for e-health - Interreality
- that integrates contextualized assessment and treatment within a hybrid environment,
bridging the physical and the virtual worlds. According to this premise, the aim of
this study is to investigate the advantages of using advanced technologies, in combination
with cognitive behavioral therapy (CBT), based on a protocol for reducing psychological
stress.

Methods/Design

The study is designed as a randomized controlled trial. It includes three groups of
approximately 50 subjects each who suffer from psychological stress: (1) the experimental
group, (2) the control group, (3) the waiting list group. Participants included in
the experimental group will receive a treatment based on cognitive behavioral techniques
combined with virtual reality, biofeedback and mobile phone, while the control group
will receive traditional stress management CBT-based training, without the use of
new technologies. The wait-list group will be reassessed and compared with the two
other groups five weeks after the initial evaluation. After the reassessment, the
wait-list patients will randomly receive one of the two other treatments. Psychometric
and physiological outcomes will serve as quantitative dependent variables, while subjective
reports of participants will be used as the qualitative dependent variable.

Discussion

What we would like to show with the present trial is that bridging virtual experiences,
used to learn coping skills and emotional regulation, with real experiences using
advanced technologies (virtual reality, advanced sensors and smartphones) is a feasible
way to address actual limitations of existing protocols for psychological stress.